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Is ASCT Feasible in Selected Older Patients With Multiple Myeloma?

By: Joshua D. Madera, MD
Posted: Friday, November 17, 2023

Autologous stem cell transplantation (ASCT) in patients older than age 65 who have multiple myeloma remains a controversial treatment strategy, with a limited amount of literature examining its impact in this patient population, explained Cristian Maximiliano Seehaus, MD, MSc, of the Hospital Italiano de Bueno Aires, and colleagues. According to a study published in Hematology, Transfusion and Cell Therapy, the use of ASCT in a real-world study of this patient population achieved response and survival rates similar to those of younger patients.

“Chronological age alone is not an exclusion criterion for transplantation, and it should be evaluated together with comorbidities and the physical condition of the patients,” noted the investigators.

From 2008 to 2018, a total of 221 patients with multiple myeloma were retrospectively analyzed. All patients had previously undergone ASCT. Patients were stratified into two groups: those aged 65 or older (group 1) and those younger than 65 (group 2). A cytogenetic risk was calculated for all patients using karyotype and fluorescent in situ hybridization.

The study authors did not identify any significant differences in neutrophil and platelet engraftment between the treatment groups. In addition, no significant differences were revealed in the incidence of treatment-related mortality the median days of hospitalization, and life support requirement during hospitalization. An increased rate of complete responses and stringent complete responses was observed in both group 1 (44%) and group 2 (37%). Furthermore, the study authors did not deem age to be a modifying factor impacting progression-free survival at 3 years (48 months in group 1 vs. 53 months in group 2) or overall survival at 5 years (75% vs. 74%).

Disclosure: The study authors reported no conflicts of interest.

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